Department of Health and Social Care

Health Services: Coronavirus

Lord Balfe: To ask Her Majesty's Government what steps they have taken to ensure that medical professionals received guidance on how (1) to differentiate between, and (2) to treat, patients with varying severity levels of COVID-19 infections.

Lord Bethell: During the COVID-19 pandemic, NHS England and NHS Improvement have published a comprehensive range of online only guides for use by clinical staff and National Health Service managers to support the management of patients.Clinical guide for the management of emergency department patients during the coronavirus pandemic, published on 17 March, sets out the categories of acute patients to consider for obligatory inpatient emergency admissions, as well as a flowchart for emergency department attendances and key steps in optimising the acute care pathways for all patient groups.Reference guide for emergency medicine, published on 22 April, includes an algorithm agreed with the British Society of Thoracic Imaging that focuses on disease severity and differentiation from other diseases.Guidance for the role and use of non-invasive respiratory support in adult patients with COVID19 (confirmed or suspected), published on 6 April, should be used to guide clinicians on the appropriate use of continuous positive airway pressure, non-invasive ventilation, and high flow nasal oxygen in patients with confirmed or suspected COVID-19. It is designed to provide a useful aid to use alongside clinical judgement and can be adjusted to suit individual clinical environments.

Incontinence: Health Services

Baroness Masham of Ilton: To ask Her Majesty's Government, further to the Written Answer byLord Bethell on 10 November (HL8072), what progress they have made on the National Bladder and Bowel Health Project, including (1) who is serving on the panels, and (2) what the timescales are for the next phases of the project.

Lord Bethell: The National Bladder and Bowel Health (NBBH) project was paused at the start of the COVID-19 pandemic in line with some other national programmes and membership of the project’s panels and timescales for the next phases of the project are not confirmed at this time.Sue Doheny, Chief Nurse NHS England, is the Senior Responsible Officer for the Excellence in Continence Care Programme which oversees the NBBH project. The project includes representatives from across the health and care profession – patients and carers, suppliers and procurement.

Medical Equipment: Import Duties

Baroness Masham of Ilton: To ask Her Majesty's Government what assessment they have made of the level of tariff that would beintroduced by the UK Global Tariff regime in the event of a no-deal Brexit on adhesive removal sprays for use with incontinence sheaths and stoma products; what assessment they have made of the impact of such a change on patients; and which other essential products for medical use will be subject to such tariffs.

Lord Bethell: Our ambition is to ensure there are no tariffs, fees, charges or quantitative restrictions on trade in goods between the United Kingdom and the European Union at the end of the transition period through a Free Trade Agreement. We therefore do not expect the UK Global Tariff to apply to EU imports. We are currently in an intense phase of negotiations with the EU and we are working hard to achieve that.

Coronavirus: Death

Lord Balfe: To ask Her Majesty's Government what estimate they have made of the number of potential additional deaths during any reasonable worst case scenario of a peak in COVID-19 infections during the winter period resulting from continued disruption of routine treatment for non-COVID-19 patients.

Lord Balfe: To ask Her Majesty's Government what assessment they have made of the impact on public confidence in the safety of returning to work and schools of the forecasted number of deaths resulting from a reasonable worst-case scenario in a resurgence of COVID-19 during the winter being double that that has already occurred.

Lord Bethell: The Government has undertaken no specific assessment. The Scientific Advisory Group for Emergencies reviewed a paper on direct and indirect impacts of COVID-19 on excess deaths and morbidity in July, which provides a scenario-based estimate for additional deaths that may result from the changes necessary to routine care during the first six months of the pandemic. A copy of the paper is attached.Direct and indirect impacts of COVID-19 (pdf, 2797.9KB)

NHS: Finance

Lord Pendry: To ask Her Majesty's Government what assessment they have made of the need to increase NHS funding (1) to maintain, and (2) to improve on, existing standards in the light of the increased expenditure required to manage the COVID-19 pandemic.

Lord Bethell: The Chancellor of the Exchequer has been clear that the National Health Service will get whatever funding it needs to respond to COVID-19.In July, the Chancellor announced an extra £31.9 billion of support for health services and on 24 September, an additional £16.4 billion for health services. As part of this funding we have provided funding to a £3 billion package of additional capacity initiatives to support the NHS through the winter, including keeping the Nightingale hospitals capacity available during winter, accessing increased capacity from independent sector providers, and supporting increased safe discharge of patients from NHS hospitals.

Care Quality Commission

Lord Hunt of Kings Heath: To ask Her Majesty's Government what assessment they have made of the decision of the Care Quality Commission (CQC) to use the word "gender" in place of the word "sex" in its communications; and what assessment they have made of the impact of that decision on the suitability of the CQC to undertake an impartial review of the Gender Identity Services for children and young people at the Tavistock and Portman NHS Foundation Trust.

Lord Hunt of Kings Heath: To ask Her Majesty's Government what discussions they have had with the Care Quality Commission about the compliance with the Equality Act 2010 of its decision to use the word “gender” instead of “sex” in its Equality, Diversity and Human Rights Policy and its Principles of Workforce Equality Monitoring document.

Lord Hunt of Kings Heath: To ask Her Majesty's Government, further to the decision of the Care Quality Commission (CQC) to use the word “gender” in place of the word “sex” in its communications, what assessment they have made of the suitability of the CQC to assess whether the bodies it inspects are applying single-sex exemptions in accordance with the Equality Act 2010.

Lord Bethell: The Care Quality Commission (CQC) have used the word ‘gender’ instead of ‘sex’ in their Equality, Diversity and Human Rights Policy and Principles of Workforce Equality Monitoring since these documents were introduced in 2011. These documents were reviewed by the CQC’s Staff Equality Networks and approved by the CQC’s Joint Negotiating and Consultation Committee, including trade union representatives and senior CQC managers, alongside external, national union officers, and were signed-off by the CQC Board at that time. The CQC complete Equality Impact Assessments for new Human Resources policies, but this use of wording did not arise as an issue of concern at the time, has not been subject to a specific assessment and was not the subject of legal advice at the time. Government Legal Services have now reviewed our use of the word gender in these documents and confirmed that this meets the requirements of the Equality Act 2010. The CQC are committed to equality and human rights throughout their work, and this approach underpins the way in which they register and inspect services. The decision has no impact on the CQC’s ability to ensure that health and social care services provide people with safe, effective, compassionate, high-quality care.

Antibiotics

Baroness Bennett of Manor Castle: To ask Her Majesty's Government what plans they have (1) to encourage, (2) to support, and (3) to enforce, the use of antibiotic consumption data as a public health measure in decisions about (a) trade policy, and (b) the protection of public health.

Lord Bethell: Public health issues are being actively considered as part of the Government’s trade policy development. The Government has been clear that it will uphold the United Kingdom’s high levels of public, animal, and plant health.The UK’s five-year national action plan for antimicrobial resistance includes ambitions to reduce antimicrobial use in human and animal medicine. Public Health England (PHE) works with the National Health Service to develop and maintain robust surveillance systems for monitoring and reporting trends in antimicrobial use. Local data on antibiotic prescribing is published by PHE in an online only format and can be used by healthcare staff, commissioners and directors of public health to benchmark performance and develop local action plans.

Contraceptives and Hormone Replacement Therapy

Baroness Greengross: To ask Her Majesty's Government whether, and if so, why there is a shortage of (1) widely used contraceptive preparations, and (2) hormone replacement therapy products; why (a) Brevinor, (b) Eloine, (c) Norimin, (d) Synphase, (e) Tisnell, and (f) Zoely, oral contraceptive tablets are currently unavailable; when they estimate that those tablets will be resupplied; and what steps they are taking to ensure the continued availability of all contraceptive preparations and HRT products.

Lord Bethell: The overall supply position of hormone replacement therapy (HRT) products has been improving since the end of February 2020 and will continue to improve in the coming months.We have been advised that supplies of Brevinor, Norimin and Synphase tablets will be available from late January/early February 2021, with supplies of Yiznell available from early January 2021. Supplies of Eloine and Zoely tablets remain available via the usual routes.Issues such as regulatory or manufacturing problems, problems accessing supplies of pharmaceutical raw ingredients and commercial decisions to divest certain products can affect the supply of medicines, including HRT and oral contraceptives.

Foreign, Commonwealth and Development Office

Nagorno Karabakh: Cluster Munitions

The Lord Bishop of Leeds: To ask Her Majesty's Government what assessment they have made of the use, if any, of cluster munitions during the recent conflict in the Nagorno-Karabakh region.

Lord Ahmad of Wimbledon: We are aware of allegations that cluster munitions were deployed in the Nagorno-Karabakh conflict. The Minister for the European Neighbourhood and the Americas has raised the alleged use of cluster munitions with both the Armenian and Azerbaijani Foreign Ministers.

Nagorno Karabakh: Peace Negotiations

The Lord Bishop of Leeds: To ask Her Majesty's Government what assurances they have sought for the safety and rights of Armenian populations in territories ceded to Azeri control under the ceasefire agreement brokered by the government of Russia.

Lord Ahmad of Wimbledon: The UK Government welcomes the ceasefire agreement between Armenia and Azerbaijan. The Minister for the European Neighbourhood and the Americas spoke to Azerbaijani Foreign Minister Bayramov on the 13 November and welcomed Azerbaijan's commitment to keep the Lachin Corridor open to allow the free movement of people between Nagorno-Karabakh and Armenia. The governments of both Azerbaijan and Armenia should continue to work closely with the Minsk Group Co-Chairs to ensure the safety and protection of all civilians.

Nagorno Karabakh: Refugees

The Lord Bishop of Coventry: To ask Her Majesty's Government what steps they are taking to address the humanitarian needs of people in Armenia who have been displaced by the conflict in the Nagorno-Karabakh region.

Lord Ahmad of Wimbledon: On 30 October the Foreign Secretary announced £1 million in funding to the ICRC to support their humanitarian efforts in the region. We are working with international partners and NGOs to understand needs in the region and what further support we can provide. The UK Government is supporting the wider international response by funding additional monitoring and analysis of the humanitarian situation through organisations such as the Humanitarian 2 Humanitarian network and supporting additional posts within the UN offices in-country. We continue to urge both sides to ensure the safety and security of all displaced persons including through recent calls between the Minister for the European Neighbourhood and the Americas and the Armenian and Azerbaijani Foreign Ministers. The UK Government is keeping the situation under close review, coordinating with local and international partners and will continue to explore opportunities to support partners to deliver an effective international response.

Nagorno Karabakh: Minorities

The Lord Bishop of Coventry: To ask Her Majesty's Government what steps they are taking to provide for the protection for minority communities in the Nagorno-Karabakh region.

Lord Ahmad of Wimbledon: We are monitoring the situation closely and are engaging with both the Armenia and Azerbaijani Governments to highlight the importance of protecting all civilians in the Nagorno-Karabakh region, including minority groups.

Ministry of Defence

Armed Conflict: White Phosphorus

Lord Alton of Liverpool: To ask Her Majesty's Government, further to the Written Answer byLord Ahmad of Wimbledon on 24 November (HL10150), what steps they are taking toreview the designation of white phosphorus as “a legitimate obscurant”; and what assessment they have made of whether it constitutes a war crime when white phosphorous is used as a weapon against civilian populations.

Baroness Goldie: The use of white phosphorous in smoke grenades, decoy and countermeasure equipment and signalling flares is not prohibited under International Humanitarian Law. Incendiary weapons, including incendiary weapons containing white phosphorous, are governed by Protocol III of the UN Convention on Certain Conventional Weapons (CCW) which prohibits incendiary weapons being deployed against civilians or military targets within a concentration of civilians. Intentionally directing attacks against a civilian population, irrespective of the weapon, is a serious violation of International Humanitarian Law and a war crime under the Rome Statue.

Scotland Office

Self-determination of States: Shetland

Lord Goodlad: To ask Her Majesty's Government what discussions they have held, if any, with the Scottish Government about the decision of Shetland Council on 9 September to approve a motion for "exploring options" for achieving "financial and political self-determination"; and what has been the outcome of any such discussions.

Viscount Younger of Leckie: The UK Government has not held discussions with the Scottish Government about the decision of Shetland Council on 9 September to approve a motion for “exploring options” for achieving “financial and political self-determination”. We recognise the importance of Shetland and its proud traditions and contribution to the United Kingdom. The United Kingdom Government has already demonstrated commitment to devolution of power in areas such as Greater Manchester and Greater London as well as in Scotland. We are keen to see power sit at the most appropriate level of government, including local government, and there is much that the Scottish Government could learn from United Kingdom Government practice in that respect.

Treasury

Motor Vehicles: Northern Ireland

Lord Empey: To ask Her Majesty's Government what additional VAT will be paid by consumers in Northern Ireland who buy second-hand vehicles transported from Great Britain after the end of the transition period for the UK's departure from the EU.

Lord Agnew of Oulton: The VAT paid by consumers buying second-hand vehicles will depend on the circumstances of the transaction and the seller of the vehicle. The Northern Ireland Protocol frames the approach to VAT on goods, including the second-hand margin scheme, in Northern Ireland. As is the case for tax policy generally, the Government is keeping this under review.

Department for Digital, Culture, Media and Sport

Sports Competitors: Females

Baroness Grey-Thompson: To ask Her Majesty's Government what plans they have to address the stigma associated with menstruation for women and girls in sport.

Baroness Barran: Periods should never be a taboo subject. Women and girls should feel comfortable discussing their menstrual cycle, and how it affects their attitude to sport and their sporting performance.We are determined to encourage more women and girls to get active and break down the barriers that prevent them from doing so, something we set out in our sport strategy Sporting Future. Sport England’s This Girl Can campaign was created to get more women active regardless of shape, size and ability, and aims to tackle head on the social barriers that can prevent women from feeling like they can join in. The latest phase of the campaign, launched earlier this year, addressed periods, showing a tampon string towards the end of the advert. The reaction to this in the press and in online discussion was overwhelmingly positive with a recognition that it shows the truth of women’s lives.Sport England are also supporting the government taskforce to tackle period poverty, primarily around actions to tackle the stigma relating to women in sport, and particularly their impact on teenage participation in physical activity in schools.In addition, we welcome the work that the English Institute of Sport is doing through their SMARTHer campaign to open up conversations amongst athletes, coaches and staff in high performance sport around athletes’ menstrual cycles in order to improve support.